3 total
Application for catastrophic impairment designation and accident benefits dismissed due to surveillance evidence and pre-existing conditions.
The applicant sought statutory accident benefits following a motor vehicle accident, claiming catastrophic impairment under criteria 7 and 8, attendant care benefits, and physiotherapy services.
The Tribunal found the applicant was not catastrophically impaired, preferring the respondent's medical assessors and surveillance evidence which demonstrated the applicant maintained an active lifestyle and had significant pre-existing psychiatric conditions that were not properly accounted for by his own assessors.
The Tribunal also dismissed the claims for attendant care and physiotherapy, finding the applicant was capable of managing his daily activities independently and had reached maximum therapeutic benefit from prior treatments.
Applicant found not catastrophically impaired; most treatment plans denied except for a chronic pain assessment.
The applicant sought statutory accident benefits following a 2016 motor vehicle accident, claiming catastrophic impairment under Criteria 7 (55% whole person impairment) and Criteria 8 (marked impairment in three of four domains).
The Licence Appeal Tribunal found the applicant's whole person impairment was 47%, falling short of the 55% threshold, and that he did not suffer marked impairment in social functioning.
The Tribunal denied most of the disputed treatment and assessment plans, finding them not reasonable and necessary, but approved a $2,665.50 chronic pain assessment.
Claims for attendant care benefits, an award for unreasonable delay, and costs were dismissed.
Application for catastrophic impairment designation and physiotherapy benefits dismissed for lack of supporting evidence.
The applicant sought a determination that she sustained a catastrophic impairment as a result of a 2018 motor vehicle accident, along with entitlement to a physiotherapy treatment plan, an award, and interest.
The adjudicator found that the applicant failed to prove she met the criteria for catastrophic impairment under Criteria 6 (physical), 7 (combined physical and psychological), or 8 (mental/behavioural).
The adjudicator rejected the applicant's expert evidence, finding it inconsistent with the AMA Guides and unsupported by objective medical evidence.
The claim for the physiotherapy treatment plan was also dismissed as the applicant failed to include the plan in evidence or prove it was reasonable and necessary.
Consequently, the claims for an award and interest were dismissed.
No co-appearing lawyers found.
No judges found.